The aim of the proposed study is to broaden current conceptualization of the coping and adjustment process in child cancer survivors to include spirituality as an additional predictor of positive health outcomes. The immediate goals of the project are: 1) to develop a reliable and validated child measure of spiritual coping and 2) to subsequently examine the relationship between spiritual coping and psychosocial adjustment in the pediatric oncology population. To address the first aim, a semi-structured spirituality interview (created for purposes of this project) will be converted to items for inclusion in the first draft of the spiritual coping measure, which will be subsequently administered to a second sample of children with the same age and treatment parameters (n=70). Factor analysis will be conducted on these items, and items that do not fit into the emergent factors will be dropped from the final measure. The primary hypothesis associated with the second aim is that child cancer survivors' use of spiritual coping will be predictive of better post-diagnosis adjustment, operationalized by lower depression and anxiety and heightened quality of life. Multiple regression will be utilized to analyze this hypothesis. The study time line allows for subject recruitment, development and implementation of the spiritual coping measure, as well as final data analyses and report writing. The proposed study is an imperative step toward increasingly comprehensive assessment of the coping and adjustment processes in the child cancer population. Findings from the investigation will guide the restructuring of coping interventions, increasing efficacy via specific assessment and treatment techniques that target domains of coping salient to the pediatric oncology population above and beyond current coping conceptualizations.